Weight Loss Surgery Burlington IA

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Growth hormone treatment for six months after weight loss surgery reduces patients' losses in lean body mass and skeletal muscle mass, according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

Weight loss surgery techniques, such as gastric banding, have been shown to be effective in reducing body weight and obesity-related diseases, such as diabetes . Although the results of these procedures are widely beneficial, there are some complications. Following surgery, patients are at risk of losing needed lean body mass and skeletal muscle mass due to the serious complications associated with rapid and sustained weight loss. This new study investigated whether growth hormone treatment could prevent or reduce these losses.

"Besides its more commonly known effect on linear growth during childhood, growth hormone benefits body composition throughout life by increasing muscle mass and reducing fat mass," said Dr. Silvia Savastano, M.D., Ph.D., researcher at University Federico II of Naples in Italy and lead author of the study. "The results of our study show that the use of short-term treatment with growth hormone during a standardized program of low calorie diet and physical exercise is effective in reducing the loss of muscle mass and increasing the loss of fat mass after bariatric surgery."

In this study, Dr. Savastano and her colleagues evaluated women who underwent laparoscopic-adjustable silicone gastric banding surgery and were diagnosed with growth hormone deficiency after the procedure. These women were divided into two groups where both groups participated in a standardized diet and exercise program, but only one group also received growth hormone. After a follow-up period of six months, women receiving growth hormone experienced a significant decrease of fat mass and an increase in lean body and skeletal muscle mass.

"This evidence opens a new frontier for growth hormone therapy in the management of morbidly obese patients," said Dr. Savastano. "However, growth hormone treatment can be costly and a careful cost-benefit analysis that also takes into account the cost of commonly used therapy for management of morbidly obese patients is needed."

Other researchers working on the study include Carolina Di Somma, Francesco Orio, Gaetano Lombardi, and Annamaria Colao of University Federico II of Naples in Italy; and Salvatore Longobardi of Merck-Serono Italia in Rome, Italy.

The article "Growth Hormone Treatment Prevents Loss of Lean Mass after Bariatric Surgery in Morbidly Obese Patients," will appear in the March 2009 issue of JCEM.

About Bariatric Surgery

Bariatric surgery is a term derived from the Greek words: weight and treatment. In simple terms, bariatrics concerns the causes, prevention and treatment...

Special Plastic Surgery Needed for Soaring Obese Population

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An article in the June, 2006, issue of Plastic Reconstructive Surgery by the leading practitioner of new plastic surgery techniques for America's growing obese population, describes in detail how improved mid-body lift contouring techniques trim away the massive amounts of excess skin in the post-bariatric surgery population.

The number of surgical body-contouring procedures performed on post-bariatric surgery patients after significant weight loss is soaring (up 22 percent from 2004 to 2005 alone) according to the American Society of Plastic Surgeons. An article in the June, 2006, issue of Plastic Reconstructive Surgery by the leading practitioner of these techniques describes in detail how improved mid-body lift techniques trim away the massive amounts of excess skin in the post-bariatric surgery population.

"The radical weight loss following gastric by-pass leads to improved blood pressure, and in many patients improves or eliminates diabetes symptoms," said Berish Strauch, MD, chairman of the Department of Plastic and Reconstructive Surgery at Montefiore Medical Center, and author of the paper. "Nevertheless, patients are left with a massive sagging of the entire body that leads to severe medical and cosmetic deformities," said Dr. Strauch, who now finds that 80 percent of his surgical practice involves post-bariatric surgery patients. "It is truly gratifying to be able to give these patients the body they have dreamed of having."

"A traditional abdominoplasty (tummy tuck) is insufficient for these patients, who after this kind of extreme weight loss require a special operation called a circumferential adbominoplasty, a type of complicated, mid-body lift, which we have modified," said Dr. Strauch.

"We trim excess skin from the stomach, thighs and buttocks in one operation, rotating the patient carefully on the operating table during the surgery," Dr. Strauch said. "At a later date, we perform plastic surgery on other areas of the body. This staged approach improves the patients' quality of life, has wonderful esthetic results and has proven to be safe and effective."

Dr. Strauch describes 75 mid-body lift operations in the article. He has performed more than 300 of these new procedures in the past five years.

Circumferential abdominoplasty is more extensive than a standard tummy tuck, and involves additional operating room time, more blood loss and increased recovery time, the article says. After recovery, typically three months later, further body contouring procedures are considered such as brachioplasty (trimming underarm 'wings') as well as breast, thigh, face, neck and back lifts.

Each of these procedures requires special techniques for formerly obese patients, said Dr. Strauch.

He notes a remarkably low incidence of complications. Only one patient has experienced ...

Weight Loss Surgery Types

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Bariatric surgery is a term derived from the Greek words: weight and treatment. In simple terms, bariatrics concerns the causes, prevention and treatment of severe overweight, a condition known as obesity. Bariatric operations are major gastrointestinal procedures which alter the capacity and/or the anatomy of the digestive system. Some bariatric procedures are performed using general anesthesia via a midline abdominal incision. Some bariatric surgeons also use laparoscopic surgical techniques, involving smaller instruments connected to cameras through which they view the operational site. Bariatric weight loss surgery fall into three general categories:

Restrictive procedures, like Lap Band®, which make the stomach smaller to limit the amount of food intake. Currently, most obesity clinics and bariatric centers favor the Lap Band adjustable gastric banding procedure and the Proximal Roux-en-Y Gastric Bypass.

Malabsorptive techniques, which reduce the amount of intestine that comes in contact with food so the body absorbs fewer calories.

Combination operations, - such as Roux-en-Y gastric bypass which employ both restriction and malabsorption. Combination operations reduces stomach capacity and bypasses the upper part of the small intestine, causing a reduction in the number of calories and nutrients which the body absorbs. Stomach bypass operations differ in both how the stomach is sectioned (stapling, banding or gastrectomy), and how much of the duodenum and jejunum are bypassed.

Gastric Bypass Operations

Gastric Bypass Operations are combination operations. That is, they combine both restrictive and malabsorptive techniques:

Create a small stomach pouch to restrict the amount of food you can eat.

Construct a bypass of the duodenum and other parts of the small intestine to cause malabsorption.

There are two types of gastric bypass procedures:

Roux-en-Y Gastric Bypass (RGB). This is the most common bariatric procedure. First, we create a small stomach pouch with staples or a vertical band. This restricts food intake. Then, we attach a Y-shaped section of the small intestine to the pouch to allow food to bypass the first and second segments of the small intestine. This reduces your body's ability to absorb nutrients and calories.

DISTAL Gastric Bypass (Duodenal Switch, Biliopancreatic Division). In this procedure, a portion of the stomach is removed. The remaining small pouch is then directly connected to the last portion of the small intestine. The risk for nutritional deficiencies is highest with this procedure.

Restriction Operations

There are two types of restrictive operations:

Gastric banding ("lapband"). A band of special material is placed around the upper end of the stomach. This creates a small pouch and narrow passage into the rest of the stomach.

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